國家衛生研究院 NHRI:Item 3990099045/15094
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/15094


    Title: The experience of neoadjuvant chemotherapy versus upfront surgery in resectable pancreatic cancer. a cross sectional study
    Authors: Su, YY;Chao, YJ;Wang, CJ;Liao, TK;Su, PJ;Huang, CJ;Chiang, NJ;Yu, YT;Tsai, HM;Chen, LT;Shan, YS
    Contributors: National Institute of Cancer Research
    Abstract: BACKGROUND: Upfront resection (UR) followed by adjuvant chemotherapy remains the standard treatment for resectable pancreatic cancer. There is increasing evidence suggesting favorable outcomes toward neoadjuvant chemotherapy followed by surgery (NAC). METHODS: All clinical staging with resectable pancreatic cancer patients treated at a tertiary medical center from 2013 to 2020 were identified. The baseline characteristics, treatment course, surgery outcome, and survival results of UR or NAC were compared. RESULTS: Finally, in 159 resectable patients, 46 patients (29%) underwent NAC and 113 patients (71%) received UR. In NAC, 11 patients (24%) did not receive resection, 4 (36.4%) for comorbidity, 2 (18.2%) for patient refusal and 2 (18.2%) for disease progression. In UR, 13 patients (12%) were unresectable intraoperatively; 6 (46.2%) for locally advanced and 5 (38.5%) for distant metastasis. Overall, 97% of patients in NAC and 58% of patients in UR completed adjuvant chemotherapy. As of data cut-off, 24 patients (69%) in NAC and 42 patients (29%) in UR were still tumor free. The median recurrence-free survival (RFS) in NAC, UR with adjuvant chemotherapy and without adjuvant chemotherapy were 31.3 months (95% CI, 14.4 - not estimable), 10.6 months (95% CI, 9.0-14.3) and 8.5 months (95% CI, 5.8-11.8), P=0.036; and the median overall survival (OS) in each group were not reached (95% CI, 29.7 - not estimable), 25.9 months (95% CI, 21.1-40.5) and 21.7 months (12.0-32.8), P=0.0053. Based on initial clinical staging, the median OS of NAC was not significantly different from UR with a tumor ≤2 cm, P=0.29. NAC patients had a higher R0 resection rate (83% vs. 53%), lower recurrence rate (31% vs. 71%), and harvested median number LN (23 vs. 15). CONCLUSION: Our study demonstrates that NAC is superior to UR in resectable pancreatic cancer with better survival.
    Date: 2023-09-01
    Relation: International Journal of Surgery. 2023 Sep 1;109(9):2614-2623.
    Link to: http://dx.doi.org/10.1097/js9.0000000000000495
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1743-9159&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:001085771100006
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85174080519
    Appears in Collections:[Li-Tzong Chen] Periodical Articles
    [Nai-Jung Chiang] Periodical Articles
    [Yung-Yeh Su] Periodical Articles

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